Understanding Dementia

It’s not uncommon for people to refer to Dementia and Alzheimer’s disease as if they were interchangeable terms.  However, this isn’t the case; Dementia refers to a group of disorders that cause a loss of memory, clarity of thought, communication, and thinking skills, to the point of impairing day-to-day life.  Alzheimer’s, for instance, is a specific form of Dementia.   Most often, its associated with aging, though that’s not always the case.

Types of Dementia

Around 60% of Dementia cases are from Alzheimer’s, a slow degradation in mental capacity caused by a build up of a protein in the brain (called plaque)

Some of the other forms of dementia include:

  • Vascular dementia:  Associated with strokes, vascular dementia
  • Dementia with Lewy bodies (DLB):  Abnormal clumps of the protein alpha-synuclein in the brain, particularly in the cortex.
  • Frontotemporal dementia:  FTD usually occurs much earlier in life than Alzheimer’s does, starting around 40 years old in some cases, and about 30% of the time it’s a genetic disorder.
  • Parkinson’s disease:  Similar to Dementia with Lewy Bodies, but the protein clumps occur in an area deeper in the brain, the substantia nigra, along with potential degradation of the nerves.
  • Creutzfeldt-Jakob disease:  One particular variant of this disease has seen the news quite often over the years:  “Mad Cow Disease”.  While there is some cases that have happened that are specifically the bovine disease contracted by humans, we also have our own variant of the disease.
  • Normal pressure hydrocephalus:  A buildup of fluid on the brain, causing pressure and dementia symptoms.
  • Huntington’s Disease:  Huntington’s is a genetic disorder, caused by a single defective gene.
  • Wernicke-Korsakoff Syndrome:  WKS is actually two disorders, often found together;  Wernicke’s encephalopathy and Korsakoff’s syndrome.WKS is caused by a severe deficiency of vitamin B1, usually brought on by alcoholism.
  • Mixed dementia:  It’s possible to have more than one dementia cause happening at the same time.  Mixed Dementia is no longer thought to be particularly rare.

There are also a few other less common forms associated with other diseases such as Multiple Sclerosis and HIV when not taking antivirals.  As you might have guessed, with this many different types of diseases, we’re not going to get into the specifics of all of them, instead focus on the overall grouping of disorders.  However, in the future, we’ll be taking a closer look at Alzheimer’s, Parkinson’s Disease, and a few mentions will come up in our article on Multiple Sclerosis.

Treatment and Dementia

For most forms of Dementia and Dementia related diseases, there are no cures.  Medications for memory, mood, sleep, and various complications are available.  Those will help extend the amount “good days” available to a dementia sufferer.

There are, however, some forms of dementia that are somewhat treatable, and even potentially reversible in certain situations.  Normal Pressure Hydrocephalus can potentially be reversed, depending on how long the condition has existed, by putting in a splint to drain fluid off the brain.  Vascular dementia can see some relief at times with the normal treatment of a stroke.  If WKS is only Wernicke’s Encephalopathy and hasn’t progressed to full WKS, it can be treated with thiamin.

Living With Dementia

The best rule for you, if you’ve been diagnosed with dementia is “plan ahead.”  Even if you’re in very early stages, you’ll want to start building up good habits, and have a plan for when you enter the later stages of dementia.  What good habits?

  • Get a diary, and use it.
  • Get a wall calendar to track upcoming events.
  • Develop consistent habit, such as placing you keys in the same place every time
  • If you’re using a land line (old style phone), place important number beside the phone.
  • All of your bills should be direct withdrawals from your bank account, so they always get paid.
  • If you take medication, use a weekly pill organizer.  Place it near the calendar, so you can make sure you’ve taken your medication.

Additionally:

  • Stay Active
  • Stay Social
  • Eat Right
  • Get solid rest
  • As for long term planning:  dementia is a progressive disorder.  It’s not a matter of if you’ll lose more of your mental abilities – it’s when will it happen.  All of the forms of dementia can progress at an inconsistent rate, and have “good days” and “bad days” that can deceive you about your current state.
  • Discuss it with your family.  They need to know your wishes before you’re unable to communicate them.
  • Stay in communication.  Find a family member who’s willing to talk to you daily, and contact them once a day, even if it’s just to say “Hi.”  This allows a 3rd party to keep track of your mental and physical well being, in case you’re unaware.
  • Have a living will and power of attorney ready, that way if you’re unable to continue to handle legal and financial issues, someone is.
  • Keep in touch with your medical professional.

Also have a long term care plan in mind.  When first diagnosed, you may be able to go to the doctor anytime you need.  However, as the dementia continues to progress, you may find yourself in a situation where getting out is no longer a viable option, but you’re not or willing to enter a long term care facility.  Find a medical professional that does house calls and in-home care, and interview them before you actually need them.

Outlook of Dementia Suffers

There are currently no cures for dementia, just treatments that extend life and quality of life.  But, that’s not to say that will always be the case.  There’s a lot of research going into the various forms of dementia, ranging from utilizing the body’s own immune system to attack the proteins behind most forms of dementia to blocking the over production of some proteins.  At the moment, though, many of those treatments are a ways away being ready for serious testing.

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“Multidendritic Sensory Neurons” by Balapagos, via Flickr